So I chose to pursue a career in science because I believe that some deep level in that transformative power of discovery that scientific discovery learning something new can transform our world as we know it, and yet, and over my thirty five years, there's only been a few opportunities where I could really feel how that is true and one of those moments. When I learned the results of our clinical trial that I've been working on for eight years, that was aiming to prove that a medicine taken before and after sexual exposure would be effective and safe for preventing acquisition of HIV, and so we knew that we were about to learn whether all of that work was leading to yet another failure in the future prevention field or whether we had discovered Some new way of preventing HIV

so I gathered in this windowless room in Bethesda, honey and age campus. Several of us had travelled in some cases from places as far as way as Peru. To pay their. We were sitting around the table where our studies sponsors the investigators, the statisticians worse, maybe ten or fifteen of us and we walked through the data, and we heard for the first time that people who had taken the drug did not get HIV infected. There was a round of applause. They just they clapped. There was nothing to say people were stunned. I think people realise that everything was different, that everything was

change. Scientists are celebrating, went for calling a major breakthrough in the fight against AIDS. A new study finds taking a drug called vodka before exposure. They each ivy reduces the risk of infection and gay men by up to seventy three percent. This is the first time is. Study has been done to choose the taking it Therefore, exposure to HIV can prevent infection to think that we are in an era now, for the first time when we can foresee the end of the epidemic, from a new times. Unlike up over this is the daily today Doktor Robert Grand develop a tree. That could finally saw the HIV crisis. Why it has

it's Wednesday June as I was graduating. I remember talking to the dean of students and he says what what do you want to do with your medical career, and I said well, I'm can work on HIV Research and he says, oh goodness, Bob don't do that. Why ways had by the time you are fully trained. The epidemic would be over to this day. I dont know if he was overly optimistic about how long it was gonna take for the epidemic the end or whether he was overly pessimistic about how long it will take me to be fully trained and other case. I just became really clear that this is ok with me. If the epidemic ended right tomorrow, I would retire and go fishing and tell stories about how there was a deadly disease that was among us, for, while in disrupted, are connections and our sex life and killed people when they were young for no reason

after years of doing research in the early two thousands into treating HIV, he turns its focus. To trying to prevent HIV in the concept comes up with is pre exposure, Prophylaxis or Prep Donald G, Macneil Junior has been covering HIV for decades, which means taking one pill of HIV Medicine per day, a small. Those too thank you for getting the disease. You know, I remember you know saying what the next big task here is is the vaccine we need of an HIV vaccine, and yet you know try after try. The vaccines for HIV were not proven to be effective, and that's when I think that many of us became interested in the possibility that the same into Richboro drugs that were good for treatment could also be used for prevention, so he puts together a trial and eventually gets funding for it from the federal government and the bill and Melinda Gates Foundation

Initial proposal was to use a medicine called ten off of here tonight, for there is a drug that, under the brandname Traviata, was already being used for HIV treatment. He wanted to see whether or not it would work for HIV Prevention and the drug that makes it was willing to donate enough doses of the trial. At that point, we chose to study Traviata for prep. Doktor grant got the impression that Traviata would soon be from under patent protection and what made you believe that that would be going off had waited. Who invented in nineteen eighty five that were colleagues and friends at Goliad, who said you know, don't worry about it by the time your research is done, and it's proven that crap is effective, for the truck would be off patent, which meant that the generic companies went into the market and make cheaper versions available soon, and that's one of the reasons he chose that drug for the trial. That was what I was led to believe. That's what I led my study sponsors to believe, and it seems clear that by

two thousand and ten the medicine would be available in generic form. I'm not quite sure how we got that impression, because Gilead argues that its patents last I took two thousand and twenty one on the drug, but every drug is covered by multiple patent. When you can patent the chemical, the process of making the chemical you can buy- dosages. You can patent delivery forms pill versus batch things like that, Many many ways to patent drug and keep your exclusive right to be the only marketer of it and so Doktor grant begins. Trial and ran two thousand and two. So this kind of a trial is being paid for by the federal government by taxpayers and private foundations, not by the pharmaceutical company. That makes this drug not by Gilgad. That's right, and giving simply donates the medicine to be used as part of this kind of ultra muttering, so he intentionally works with Julia had for, among other reasons, the idea that this drug at the end of all this, if it

worked, would be available and a relatively inexpensive way to lots and lots of people who, in theory, we were able to recruit. Two thousand five people in eleven sites and six countries, the trial lasted eight years and it was a huge success. What we found is tat. The people who had received the active form of the drug had much lower HIV infection rates and if they actually took the medicine daily, no one got infected. So then the trial ends its as Ex they ve shown that when people take this drug every day, the vast majority them don't get HIV. What happens next everybody assumed now many gonna be at the United States and old beyond it immediately. That doesn't happen one. As far as I can tell two reasons: one guilty I didn't advertise. It may never explained why. But the obvious reason is using a drug. Is a preventative, is different from

for treatment. When you treat somebody there already six of them, not like it a su when you give it to somebody who's healthy, if they happen to get sick anyway, they might suit the other. You'd reason, people and get our masses. The price tell me exactly what uprising. I think it was around four thousand dollars a year when this new, you started. And then at the prices rhythm, absurd, pretty twenty thousand dollars here at the very price tag. Yeah, it's a high price. It's a high profit margin, because we know that it only costs less than sixty dollars here to make so something that cost sixty dollars. You're getting at is charging upwards of fourteen thousand already or for correct one. That's almost fourteen thousand arson pure profit. That's the way that drug industry works in this country. Most chemicals will cost all that much to make me once you ve got a giant factory size process line going many. These drugs can be made.

Leave her pennies, a pill but because their patented- and nobody else can solemn and the seller can name his price. They name what they think the market can bear. So what kind of response has there been to the high price of job on the high price of Traviata keeps people from getting the drunk because to get over the high price for to get somebody else to pay for the drug? For you is an enormous beer. Brad a colonel you ve got to do with your insurance company or, if you're, not I'm Medicaid, you gotta get on Medicaid. If you're, not, I met a carry you gotta get. I met a care, we really there ought to be a million people on this drug in the country. That's the number of people who were a high risk of getting HIV and now

only about two hundred and seventy thousand people in the country that so they tremendously underserved market for a very effective thing that acts like a vaccine. I'm devastated that only fourteen percent of people who could benefit from proper getting at the United States and I'm devastated that the HIV transmission rates nation wide have not decreased since two thousand thirteen. You know this was twenty years of work and risk, an effort to and HIV transmission, and we all know that that it can happen if we actually use treatment and use prep, but it's hard to use price tag of two thousand one hundred dollars per person per month. It does not matter if it's not used and of its not available for everyone who needs it and it does not matter unless we can use it to end HIV transmission

find make sure all people get access to prep and comprehensive prevention store and it's terribly expensive. I think we really need to have a conversation is occurring Kennedy about how we're being taken advantage of by the drug companies and in particular, Galea. You have a reality.

wondering back as a surgeon and president of Howard, University, Doktor Wayne Frederick leaves are tough. His times can lead to strength and change. This is a difficult stormy, do it, but it was strengthened in a way that no class you will like Timothy could ever have I'm only shipper host of the past that meet all the difference I talked to achieve is about how their managing the current moment and charging a course for the future, find that made all the difference anywhere. You get your pack ass, created by Bank of America. So what is Gilias response ban to this call to make this drug cheaper and therefore, more

about the two things Gilias done. A response is they have announced that a generic company will be able to enter the field one year earlier than expected in two thousand and twenty. Instead of two thousand and twenty one, and just a few weeks ago, the Trump Administration announce it had reached to deal with Gilias Cordelia to donate, to two hundred thousand patients anywhere in the country. The jump administration and now Thursday that Galliot science, as which manufactures Traviata plans to dominate the drug for as many as two hundred thousand people for up to eleven years. How big a deal are either of those how meaningful are they having generic competition one year earlier, means that the process of the price dropping will start one year earlier. It probably won't be instantaneous. It usually takes four or five dinner companies entering the field before Bryce relayed Rob substantially in that may take longer. And two thousand free doses is an important move, but the AIDS

de MR, are suspicious of this move. Why are they suspicious because of the terms of the deal? Roughly, a million people need the drug only about two and fifty thousand are on it. So it's not gonna cover everybody who needs it and most people who needs it are poor, gay, blackened hispanic men whenever well connected the medical care system. The deal is only for eleven years, and this is a drug you need to take for life. But the other part of the deal that makes the activists most suspicious is the fact that, in the middle of the donation, everybody will be switched over from true vodka to delay adds new drug discovery as soon as its approval, Crap

discovery is a slightly different form of time off a view that supposedly has fewer side effects, although to map of Europe as a relatively safe drug and discovery, has some side effect of a tone. The fear that the activists have is that people are gonna start demanding discovery whence they ve been switched on to it, and discovery is now patented for the next twenty years and Juliet says little price it for twenty thousand bucks a year. They see this as a way of creating a market for discovering. Ah, Think I'm starting to understand. Ok, so, activists. This feels a bit like a bed and switch it's kind of insidious in the sense that its, nearly enough pills to help everyone who needs it, who can afford it and is creating a kind of financial pipeline to a new version of the drug bingo if they get used to it, discovery for two or three years, and then the donation runs out, then they're gonna clamour to stay undiscovered, even though the phone up what's gonna,

wait a minute we ve got really cheap Traviata here you know, so we Put you on that. It's making a market for new drug that otherwise would it cost them a lot of advertising money to create and its drawing up a demand for generic Traviata, because obeys gonna want or anymore right donning. Let robotic awesome almost nothing as we know that it, you know, cost less than sixty dollars here to make so the accuracy made that donation is costing less than ten million dollars ear, but their taken a tax deduction for something like the retail costs, not the cost of making. That's that's how donations work for the pharmaceutical industry. You donates under the costume pennies to make, and you take the tax adoption the dollars that you sell it for some Juliet is directly making money installation, possibly I met with the IRS, but in ferry yeah, but the larger picture is it. This is part of the Trump Administrations goal to help end the HIV epidemic, which helps american citizens, but the activists fear that the result of it is going to be

helping drug company increases profits. Is this a novel strategy to donate drugs like thus? No, it actually echoes something that happened twenty years ago when ages ravaging Africa more than thirty. Five million people around the world have AIDS and about two thirds of the more african. The death rate in Kenya is more than five hundred a day. Hiv drugs cost fifteen thousand dollars a year, drug companies did not want to lower their prices. Originally, they were just think completely turned their backs on Africa. Let people diagnosing retraction those prices and There was an enormous outcry, dead and then one day every year, and then we have about money, it

incredibly, immoral, often ignore the market so, but their first offer was to give a certain number of free or deeply discounted drugs into the market. Basically, in order to make himself look good and if you can given a free drugs into a market, you dry up the demand, and that keeps everybody quiet, because there's no need no incentive for the general, makers to get into an because it was already. There is the bills already there and meanwhile you're getting large tax deductions for the pills you're getting away. So if you can keep them out of the market, you kept an entire world of competition out of Europe field, so what killing is doing with destination is actually following a pretty well worn, playbook just doing what farmers who companies have long gone before actually in the courts. The HIV epidemic. So maybe no one should be honest, surprised that that's how display now it's one of many many market protecting plays that the drug companies companies have warned use yet

I realize now that I was naive everywhere I went. People would raise the concern that is never gonna, be inexpensive enough to actually use and that the prices always gonna be high, and with a short people that one way or another, we will find a way to lower the price to what it can be and should be, and what I regret is that I feel like I left that promise with Staying involved enough to make sure that we made good on that promise and correct for just last year that the price has been increased, stand by year and that so called efforts to make this available to everyone. Said are half hearted, I said look you know this is not correct for me. I need to get back into this and stand by the promise

that I made that we will find a way to end this epidemic, and so at one point I got a call from the house oversight, committees, staff, and they wanted to hear me talk about my story, and I told them in but a week after that they invited me to the hearing. I now want to welcome our witnesses that Robert ran professor medicine at the University of California Emphasis Shop, so Doktor grant goes and testified before Congress. A few weeks ago, I devoted the last twenty years of my career to the development of crap. I am here today at my own expense, because I promised the prep would become available if proven, We have not kept that promise. I come today to ask for your help and he basically s Congress to step in arguing that Gilias has essentially made it impossible for an affordable version of the drug to get the market. In my experience, the root cause of low prep access is the high

price and the Iliad CEO is also there testifying answering questions from Congress. Alexander Yokels, Yo Cortez from New York asks about the price and other countries, so the list presses almost two thousand dollars in United States wise it eight dollars in Australia, Traviata is still as patent protection in the United States and in the rest of the world. It is genetic so down on paper. This feels Carcinus urban. Isn't this just how the system works in this country? A farmer should accompany, has the right to defend its intellectual property, its investment, its years of work and creating these drugs, no matter how much actually technically COM to make each pill, and that's just how our market system functions. Yes, they're playing by the rules, but they help make the rules, and the big example of that is that in this country, unlike any

Their country federal agencies that by drugs from the drug companies, are not allowed to go shaped with those companies over the price of the drugs. When you go to buy a car you're, a big buyer big, take an item you can negotiate over price of the federal government is stuck, it can't negotiate price and there are very big ticket. Buyer, absolutely that's unusual, an anti business and its only in the United States that that's done, because the pharmaceutical lobby so powerful. What else conceivably? Could the? U S, government, due to bring down the cost of a struck Well, what the activists wanted to do is literally cancel the pact there is vision under american law called martian rights. This use for this drug was substantially paid for by the United States government they paid for the trial that has established prep. So If the drug is not available at a reasonable price, the government has marching rights to go and take the patent away from coming

assign to somebody out literally margin yet because of their financial stake. It would be too legal under american law to do that. The government has historically always hesitated to take away any sort of patent rights from firms industry. Why? Because they have a very powerful lobby, and is also perhaps the spectre which doesn't feel entirely american nor capitalist system of kind of nationalization, taking something from the private sector of claiming it for the public sector. Well, the actually the government does this kind of thing all the time we have a concept of eminent domain when you need to build a house you can take away somebody's home. More importantly, this is actually a license is granted by the government. That's what a patent is, so the government can take back a patent license the same way. I can take away your driving license if your hunting license. If you abused it- and there is precedent for this in the wake of the nine slash eleven attacks the country

it with anthrax. Supposedly there was only one cure for anthrax and met with Super Phloxes and bear the same company. They make aspirin held the patent on Super phloxes in and they were charging thirteen dollars a pill. The government wanted two hundred million pills for it stockpile and bear said it'll, be thirteen dollars in the government said no that's too much, and if you dont lower the price we can take away your patent on Sir Brian Bayer said: ok, the president or fifty bump, and of problem and for public health purposes. The activists are you there to be doing it, because the companies charging so much that people can't get a vaccine like medication that they need so Donald. What should we make of the fact that the government has not done any of the things that you just described to lower the price? I think make it to. The government doesn't recognise how important it is to stop this disease that you have the kind of pull out all the barriers to stop it

and that means making it as easy to get on prep as it is to get a measle shot in this country you want to stop a disease. You have to protect everybody who is at risk and you needed to make it easy to protect them either. You have. The government has to go down itself or make it really really easy and cheap for people or mother it enough to seek it out for themselves to go, get it is what you're really saying that the government does. Aids is that big of a crisis It has been around for more than thirty years now and believe me this had been available back in the early days of the epidemic. This would happen vaccines against HIV now that we ve gotta for three years and is taking a long time to create these drugs and then realize that they can be used for prevention to those like the government's interest, as has has waned, If you don't see people dying of HIV anymore, so you don't worry about. It will unfortunately most people getting HIV now are poor and why, living in the south, not gain well educate

didn't living in New York City. So the political arm twisting that. As on when you have a large powerful lobby in New York City in Washington DC. Just isn't there anymore I was thinking this morning that I wanted to tell you a story. This project, on over many years in and they were just so many people who gave so much to make prep research possible and there's one person I wanted dimension in particular, a sociologist that worked with me for twelve years and worked in my lab any guided the design of these studies. His name is said, Jeff Mcconnell and in two thousand fourteen. He he died. He died shortly after the end my research on prep, he was a man living with HIV infection and one other questions. I remember him asking was if we discover

a way to end the HIV epidemic. Would we and I realize now that I dont know the answer to that question. I feel like he's still asking a question If we found a way to end the HIV epidemic, would we and you know what the time I I was optimistic and I was naive, I said, of course we would if we know how to end it. We would ended and right now I have to say I'm not sure, I'm not where we had ended, because I do know that we know how to end this epidemic. We have all the technology. We need ten, this epidemic, and yet we don't we dont and this epidemic, and so I feel like I lied to Jeff. I told them see us we would, and now I have to say, I'm not sure. I am not sure

We would end the epidemic even once we know how to do it because we do know how to do it and we're not doing it all the way back. Yesterday's office plants don't match your needs of today with we work, companies have the flexibility to future proof, their business, which is ideal for navigating uncertainty, whether Europe

the house disperse teams, reconfigure offices or have flexible terms, we work can help you adapt through change to learn more about. Why a third of fortune, five hundred choose, we work, go too, we dot co, slash future, here's what else you need during a new conference in London on Tuesday with Prime Minister Teresa may, President Trump said he believed that breaks. It would eventually happened. Despite these repeated failure to negotiate a deal, I would say I would think that it will happen and it probably should happen. This is a great great country and it wants its own identity. It wants to have its own borders. It wants to. On its own affair. The president said it was in the best interest of Britain to leave the European Union and promised that the? U S would negotiate a quote phenomenal trade deal with Britain to ease

its transition out of the EU, and it is right to respond to this tragedy with decisive action led Virginia set an example for the nation that we can respond to tragedy with action on Tuesday in response to the mass shooting in Virginia Beach, Virginias governor wealth, North called a special session of the state legislature to vote on a series of gun control measures. I will propose many of the same ideas that we have proposed before universal back rancher, a ban on assault weapons to include the oppressors and bumps many of the measures proposed by north them, have already been voted down by Virginia lawmakers and they

he's an uncertain fade in the republic. Uncontrolled legislature after North M spoke, the speaker of the Virginia House of Delegates, Kirk Cox called nor thumbs request for a special session, quote hasty and suspect,

That's it for the date. I Michael will see tomorrow between two or cancellations lost, creative gags and shrinking outer avenue. The covered nineteen crisis is making it clear that the system supporting creative people is broken. Patriarch offers a better way. We help creators make up lost revenue and build a more sustainable income source by offering a monthly membership to their fans. In turn, fans get access to exclusive community premium contents and the chance to become active participants in the work. They love check out, patriarch dot com now and help change. The way art is valued,